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With atopic dermatitis, the most common form of eczema, taking good care of your skin could be the difference between a comfortable night and a night full of scratching.
An increasing number of people with atopic dermatitis are combining prescription
medications with complementary and integrative remedies to find relief.
Common practices include soaking in baths, moisturizing with
coconut oil, taking vitamin supplements, and more.
This article explains more about these nondrug therapies. However, bear in mind that scientific evidence supporting their use may be limited.
Bathing and Skincare
Atopic dermatitis triggers inflammation that damages the skin barrier — the uppermost layer of skin that typically locks in moisture. This can cause skin to be dry, prone to itchiness and rashes, and vulnerable to irritants, allergens, and viral and bacterial
infections.
Bathing Tips with Eczema
Gentle, consistent
bathing or showering habits can help you keep potential irritants in check, strengthen the skin barrier, and keep moisture in the skin. All of these may help you avoid dry, inflamed skin that can open the door to allergens or bacteria and worsen your eczema symptoms. The National Eczema Association (NEA) makes the following recommendations:
- Take at least one bath or shower a day, preferably just before bedtime.
- Bathe or shower in lukewarm (not hot) water for no longer than 10 to 15 minutes
- Use a gentle, dye-free, fragrance-free cleanser instead of soap.
- Pat skin with a towel after bathing, leaving it slightly damp, and apply prescription topical medication as necessary.
- Apply moisturizer all over the body within three minutes.
- Wait a few minutes to get dressed so the moisturizer has time to absorb into the skin.
The act of bathing, applying topical medications to inflamed areas, and then moisturizing the rest of the body is known as the soak and seal method. A doctor might also recommend wet wrap therapy, in which you wrap the affected area with damp cotton dressings and a layer of dry dressings for longer periods to keep in moisture.
Different Remedies to Add to Baths (One at a Time)
In addition to these general guidelines, some bath ingredients might ease atopic dermatitis
symptoms and help the skin retain moisture. The NEA says that you can try adding these items to bathwater one at a time, not combined. However, they also note that little evidence exists to support the safety and effectiveness of these add-ins as eczema remedies, and you should consult your doctor before trying one.
Baking Soda People often try adding a quarter cup of baking soda to a bath, and it might help to relieve itching in some people. However, there is not much evidence supporting its use for eczema, and it can disrupt your skin’s microbiome – the community of bacteria living on its surface. This can, in turn, lead to irritation or dryness.
Bleach A half cup of household
bleach — which you’ll need to add to a full tub of lukewarm water for the proper dilution (use a quarter cup for half a tub)
— may help to reduce itching by balancing the community of bacteria on the skin.
Take care to keep bleach out of eyes or cracked skin.
Gentle Bath Oils Choosing bath oils with no fragrances or bubble bath solutions can help to keep you moisturized without triggering irritation or drying out the skin like ordinary wash products. They may be useful for people with sensory issues who can’t tolerate the greasy feeling of emollients on their skin.
Bath oils aren’t the same as essential oils, which are heavily distilled, potent plant extracts that people may use in aromatherapy or to reduce skin inflammation. If you have eczema and can’t tolerate fragrance, or you find that essential oils trigger allergic contact dermatitis, avoid them in your
eczema bathing routine. Perform a skin patch test by applying a small dab onto your inner arm (just below your elbow) for 3-5 consecutive days, and avoid using them altogether on broken skin.
Epsom or Dead Sea Salt If you add 1 or 2 cups of these salts, they may soothe some eczema symptoms during severe flares due to their potential anti-inflammatory properties, their ability to kill germs, and their possible benefits for the skin barrier. However, this can also be irritating to some people, causing stinging and discomfort on skin that has severe inflammation. Avoid trying salt baths until you’ve spoken to a dermatologist about whether they're right for you.
While oatmeal baths and some other food products listed below may be soothing, other foods are not safe for use on skin.
Applying certain food products to your skin comes with risks, according to Kanwaljit K. Brar, MD, a pediatric allergist and immunologist at Allied Physicians Allergy, Asthma, & Sinus Center of Long Island, New York. “This may increase the risk for food allergy or may cause skin irritation,” she says.
Certain Oils
Some people are finding relief for irritated skin by turning to common oils. Coconut oil and sunflower seed oil are two options supported by some solid research.
Coconut Oil
Other research has found that using coconut oil on the skin can also help prevent flares.
However, the NEA cautions that it’s less useful for treating flares, even though it’s a good moisturizer.
Coconut oil can also boost hydration, improve skin elasticity, and relieve itch, and has antimicrobial properties that can reduce the chances of infection. While it can help many people prevent flares, coconut oil can trigger an allergic reaction in others, notes the NEA. Consult with your doctor before you try applying coconut oil or any other new product containing it to your skin. Also consider that products containing coconut oil might also contain potentially irritating chemicals that may worsen eczema or itching.
Sunflower Seed Oil
Sunflower seed oil may also be beneficial for atopic dermatitis (unless you are allergic to it). When applied to skin, sunflower seed oil appears to help relieve itch, reduce rashes, eliminate blisters, and improve skin barrier function.
Oils to Avoid
Not all oils are safe for your skin, even if they’re safe to eat. For example, olive oil is not recommended for skin use because it can actually reduce skin barrier function.
Essential oils are another category of oils to avoid if you have eczema. Although popular, essential oils are volatile concentrated plant extracts, notorious for causing irritation or allergy in people with eczema.
“Families will often try homemade concoctions of multiple essential oils, which I recommend against,” Dr. Brar says. “Essential oils may cause contact dermatitis [an itchy rash], and the fragrance may irritate the skin.”
Acupuncture
People with eczema frequently use acupuncture, in which a practitioner inserts thin needles into specific points on the body to rebalance energy flow.
One systematic review and meta-analysis found that acupuncture can help reduce itch intensity and ease eczema symptoms. However, the study authors recommend larger trials to help confirm these findings.
Acupuncture can also have positive effects on a person’s stress levels and overall sense of well-being.
Acupuncture is a safe treatment, and the above research found no adverse effects. However, it can be expensive, because insurance often does not cover it as an eczema treatment.
The Mind-Body Approach to Atopic Dermatitis Treatment
Some complementary and integrative treatments for atopic dermatitis focus on helping patients manage their stress.
- Hypnosis A medical hypnotherapist can induce a trance state and make suggestions that aim to reduce discomfort and promote healing.
- Biofeedback This is a relaxation or awareness technique that combines a physiological feedback device with directed thought. This can help a person feel more in control of their autonomic nervous system — the part of the nervous system that oversees bodily functions that don’t require active thought. Biofeedback can help a person with eczema gain more control over their eczema-related anxiety.
- Cognitive Behavioral Therapy (CBT) CBT uses mindfulness techniques to help people reduce distress due to chronic itching and disrupt the cycle of stress-induced itching and spontaneous scratching.
Some people with eczema practice yoga, qigong, and tai chi to help them reduce stress, lower inflammation, and distract from the itching.
Supplemental Vitamins
Vitamin D supplements have gained a lot of research attention because people with a vitamin D deficiency appear to be more likely to have atopic dermatitis and develop a more severe form of the disease.
Among the research:
- One systematic review of 11 randomized controlled trials found that taking oral vitamin D supplements reduces the severity of atopic dermatitis symptoms.
- A review found a link between low blood vitamin D levels and the severity of atopic dermatitis symptoms in adults and children.
- Another review noted that studies that have used oral supplementation have not shown a meaningful improvement in eczema severity, with the exception of participants who are very vitamin D deficient.
The authors of one review concluded that vitamin D supplementation is safe and tolerable and may help reduce the severity of atopic dermatitis in people of all ages. However, they cautioned that these findings will need to be confirmed with larger-scale, longer-term clinical studies.
Topical vitamin B12 has also been shown to ease eczema symptoms in adults and children. But no commercial product currently exists, so a specialist lab has to compound (or specially formulate it) for use in people with eczema.
Rachel Green
Rachel Davis
Derek Schulz
Sophia Martinez
Dr. Amara Okafor